Renata E Howland1, Tsu-Yu Tsao. 1. New York City Department of Health and Mental Hygiene, Long Island City, NY.
Abstract
BACKGROUND: Improving the collection and quality of race and ethnicity reported in hospital data is a key step in identifying disparities in health service utilization and outcomes and opportunities for quality improvement. OBJECTIVE: The objective of this study was to assess the quality of race/ethnicity reported in hospital discharge data and examine the impact on the identification of disparities in select health outcomes in New York City. RESEARCH DESIGN: Using the birth certificate as a gold standard, we examined the quality of hospital discharge race/ethnicity and estimated the impact of misclassification on racial/ethnic disparities in severe maternal morbidity and preventable hospitalizations. SUBJECTS: Delivery hospitalizations from the New York State hospital discharge data (Statewide Planning and Research Cooperative System) linked with 2015 New York City birth certificates. MEASURES: Sensitivity and positive predictive value (PPV). RESULTS: The non-Hispanic white and black race had relatively high sensitivity and PPV. Hispanic ethnicity and Asian race had moderate sensitivity and high PPV, but were often misclassified as "Other." As a result, health disparities may be underestimated for those of Hispanic ethnicity and Asian race, particularly for indicators that use population denominators drawn from another source. CONCLUSIONS: The quality of hospital discharge data varies by race/ethnicity and may underestimate disparities in some groups. Future research should validate findings with other data sources, identify driving factors, and evaluate progress over time.
BACKGROUND: Improving the collection and quality of race and ethnicity reported in hospital data is a key step in identifying disparities in health service utilization and outcomes and opportunities for quality improvement. OBJECTIVE: The objective of this study was to assess the quality of race/ethnicity reported in hospital discharge data and examine the impact on the identification of disparities in select health outcomes in New York City. RESEARCH DESIGN: Using the birth certificate as a gold standard, we examined the quality of hospital discharge race/ethnicity and estimated the impact of misclassification on racial/ethnic disparities in severe maternal morbidity and preventable hospitalizations. SUBJECTS: Delivery hospitalizations from the New York State hospital discharge data (Statewide Planning and Research Cooperative System) linked with 2015 New York City birth certificates. MEASURES: Sensitivity and positive predictive value (PPV). RESULTS: The non-Hispanic white and black race had relatively high sensitivity and PPV. Hispanic ethnicity and Asian race had moderate sensitivity and high PPV, but were often misclassified as "Other." As a result, health disparities may be underestimated for those of Hispanic ethnicity and Asian race, particularly for indicators that use population denominators drawn from another source. CONCLUSIONS: The quality of hospital discharge data varies by race/ethnicity and may underestimate disparities in some groups. Future research should validate findings with other data sources, identify driving factors, and evaluate progress over time.
Authors: Roger Y Kim; Katharine A Rendle; Nandita Mitra; Chelsea A Saia; Christine Neslund-Dudas; Robert T Greenlee; Andrea N Burnett-Hartman; Stacey A Honda; Michael J Simoff; Marilyn M Schapira; Jennifer M Croswell; Rafael Meza; Debra P Ritzwoller; Anil Vachani Journal: Ann Am Thorac Soc Date: 2022-09